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AB-1477 Alcohol and drug treatment programs: licensing and certification fee.(2023-2024)

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Date Published: 03/27/2023 02:00 PM
AB1477:v98#DOCUMENT

Amended  IN  Assembly  March 27, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 1477

Introduced by Assembly Member Quirk-Silva Members Quirk-Silva and Waldron

February 17, 2023

An act to amend Section 11833.02 of the Health and Safety Code, relating to alcohol and drug abuse treatment facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 1477, as amended, Quirk-Silva. Alcohol and drug treatment programs: licensing and certification fee.
Existing law makes the State Department of Health Care Services responsible for administering prevention, treatment, and recovery programs for adult alcoholism and drug abuse. Existing law requires the department to charge a fee to all programs for licensure or certification by the department and to submit any proposed new fees or fee changes to the Legislature for approval, as specified. Existing law prohibits new fees or fee changes from being implemented with without legislative approval.
This bill would require all fees for licensing of nonprofit residential treatment facilities and certification of nonprofit treatment programs that provide addiction treatment services to Medi-Cal beneficiaries to be at the rate last published in 2022. The bill would leave that rate in effect until January 1, 2034, 2031, or until deaths related to opioid overdose reported by the California Overdose Surveillance Dashboard have declined by 50%, whichever is first. The bill would then require that fee increases continue until licensing and certification programs are self-sufficient, but would prohibit the increase from exceeding 15% in a single year.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares the following:
(a) Data from the federal Center Centers for Disease Prevention and Control’s Control and Prevention’s (CDC) National Center for Health Statistics show shows that nationally there were more than 100,000 Americans who died by overdose from May 2020 to April 2021, inclusive, with more than 64,000 of these deaths being a result of synthetic opioids and fentanyl.
(b) California experienced a 45-percent increase as more than 10,800 Californians died during this time.
(c) The number of amphetamine-related emergency department visits increased by nearly 50 percent between 2018 and 2020 and the number of non-heroin-related opioid emergency room visits more than doubled in the same period.
(d) Data from the California Health Care Foundation show shows that around 8.5 percent of California’s population lives with a substance use disorder, with 6.4 percent meeting criteria for an alcohol use disorder and 3.3 percent meeting criteria for a substance use disorder involving illegal drugs.
(e) Fifty-six of 58 counties in California are not meeting network adequacy requirements for the provision of substance use disorder services.
(f) Only 40 percent of commercial HMO and PPO health plan members with an alcohol or other drug dependence diagnosis received care that met the national quality standard of an initial treatment visit within 14 days of diagnosis.
(g) About 2.7 million Californians had a diagnosable substance use disorder in the past year, and only 1 in 10 of these individuals received treatment.
(h) The State Department of Health Care Services (DHCS) instituted licensure and certification fee reduction waivers throughout the first year of the COVID-19 Pandemic Emergency to assist facilities licensed and certified by DHCS to keep their doors open and to provide critical services, thus depleting the Residential and Outpatient Program Licensing Fund reserve.
(i) Section 11833.02 of the Health and Safety Code requires the fund to be supported by fees and federal funds, unless there is a specific appropriation from the General Fund.
(j) The Legislature declares that California faces a substance use disorder emergency and resolves to temporarily freeze licensing and certification fees for treatment programs to remove disincentives to building the state’s treatment capacity.

SEC. 2.

 Section 11833.02 of the Health and Safety Code is amended to read:

11833.02.
 (a) The department shall charge a fee to all programs for licensure or certification by the department, regardless of the form of organization or ownership of the program.
(b) The department may establish fee scales using different capacity levels, categories based on measures other than program capacity, or any other category or classification that the department deems necessary or convenient to maintain an effective and equitable fee structure.
(c) Licensing and certification fees shall be evaluated annually, taking into consideration the overall cost of the residential and outpatient licensing and certification activities of the department, including initial issuance, renewals, complaints, enforcement activity, related litigation, and any other program activity relating to licensure and certification, plus a reasonable reserve.
(d) Beginning January 1, 2024, all fees for licensing of nonprofit residential treatment facilities and certification of nonprofit treatment programs that provide addiction treatment services to Medi-Cal beneficiaries shall be designated at the rate last published in 2022. This rate shall remain in effect until January 1, 2034, 2031, or until deaths related to any opioid overdose reported by the California Overdose Surveillance Dashboard have declined by 50 percent compared to the deaths on January 1, 2024, whichever is first. Upon a 50-percent reduction in overdose deaths, or after January 1, 2034, 2031, fees may be increased by not more than 10 percent per year until the Residential and Outpatient Program Licensing Fund meets the requirements set forth in subdivision (g). increased. These increases shall occur over a number of years and at a percentage to be determined based upon the estimated annual operating deficit for the licensing and certification programs. These fee increases shall continue until the licensing and certification programs funded through the Residential and Outpatient Program Licensing Fund are self-sufficient. A single-year increase prior to fund self-sufficiency shall not be more than 15 percent.
(e) The department shall submit any proposed new fees or fee changes to the Legislature for approval no later than April 1 of each year as part of the spring finance letter process. New fees or fee changes shall not be implemented without legislative approval.
(f) The department shall issue a provider bulletin pursuant to subdivision (a) of Section 11833.04 setting forth the approved fee structure. The department shall, on an annual basis, publish the current fee structure on the department’s internet website.
(g) Unless funds are specifically appropriated from the General Fund in the annual Budget Act or other legislation to support the division, the Licensing and Certification Division, no later than the beginning of the 2010–11 fiscal year, shall be supported entirely by federal funds and special funds.